Cross reactivity of spike glycoprotein induced antibody against delta and omicron variants before and after third SARS-CoV-2 vaccine dose

Variants of SARS-CoV-2 may evade natural and vaccine induced immunity and monoclonal antibody immunotherapeutics. There is an urgent need to know how well antibodies, induced by healthy and Clinically Extremely Vulnerable (CEV) patients, will bind and thus help reduce transmission and severity of infection from variants of concern (VOC). This study determines the cross-reactive binding of serum antibodies obtained prior to and 28 days after a third vaccination in three cohorts; a health care worker cohort who received three doses of Pfizer-BioNtech (PPP), a cohort of CEV patients received two doses of the AstraZeneca-ChAdOx1-nCoV-19 (AAP) vaccine, followed by a third PFZ vaccine and a haemodialysis cohort that had a mixture of two AZ or PFZ vaccines followed by a PFZ booster. Six months post second vaccine there was evidence of antibody waning with 58.9% of individuals in the HD cohort seropositive against Wuhan, 34.4% Delta and 62.2% Omicron strains. For the AAP cohort, equivalent figures were 62.5%, 45.8% and 91.7% and the PPP cohort 92.2%, 90% and 91.1%. Post third dose vaccination there were universal increases in seropositivity and median optical density. For the HD cohort, 98.8% were seropositive to the Wuhan strain, 97.6% against Delta and 100% against Omicron strains. For the PPP and AAP cohorts, 100% were seropositive against all 3 strains. Lastly, we examined the WHO NIBSC 20/136 standard and there was no loss of antibody binding to either VOC. Similarly, a dilution series of Sotrovimab (GSK) found this therapeutic monoclonal antibody bound similarly to all VOC.

PSYCHOLOGICAL IMPACT OF COVID ON HEALTH CARE WORKER DUE TO COVID 19 PANDEMIC IN A TERTIARY CARE HOSPITAL : A CROSS SECTIONAL STUDY

Background: Corona virus disease 2019 (COVID-19) pandemic caused health crisis. It is important to assess the status of stress, depression and anxiety among medical health care worker (HCWs). Material and Methods: A cross sectional study based on online questionnaire wherein sample size was 160, and HAMD, HAMA and PSS questionnaire was applied and also a self made questionnaire was applied to assess the strategies to cope with covid stress, it consists of 3 items. Data analysed using SPSS software variables compared by using Chi-square/Fishers exact test. Students t-test was used to compare mean values in the two independent groups, and one-way ANOVA was used for more than two groups. The variables with P < 0.05 were considered as statistically significant. Result: A total of 160 sample included, in which 94 (58.1%) were medical staff and 66 (41.25%) were administrative staff. Significant difference was noted in sex(p= 0.004), educational status(p= 0.000), monthly income(p= 0.000), high risk exposure(p= 0.000) and contact with COVID positive suspect or case(p=0.000).There were significant difference noted in depression, anxiety and stress scale as compared to the administrative staff group (p = 0.004, p= 0.004 and p= 0.007) respectively. Conclusions: During this COVID-19 pandemic, HCWs reported a high prevalence of depression, anxiety and stress than the administrative staff.

Perceived satisfaction with HIV care and its association with adherence to antiretroviral therapy and viral suppression in the African Cohort Study

Background Increased availability of HIV care over the past decade has dramatically reduced morbidity and mortality among people living with HIV (PLWH) in sub-Saharan Africa. However, perceived and experienced barriers to care, including dissatisfaction with services, may impact adherence and viral suppression. We examined the associations between satisfaction with HIV care and antiretroviral therapy (ART) adherence and viral load suppression. Methods The African Cohort Study (AFRICOS) is a prospective observational study conducted at PEPFAR-supported clinics in four African countries. At enrollment and twice-yearly study visits, participants received a clinical assessment and a socio-behavioral questionnaire was administered. Participants were classified as dissatisfied with care if they reported dissatisfaction with any of the following: waiting time, health care worker skills, health care worker attitudes, quality of clinic building, or overall quality of care received. Robust Poisson regression was used to estimate prevalence ratios and 95% confidence intervals (CIs) for associations between satisfaction with care and ART adherence and between satisfaction with care and viral suppression (viral load < 1000 copies/mL). Results As of 1 March 2020, 2928 PLWH were enrolled and 2311 had a year of follow-up visits. At the first annual follow-up visit, 2309 participants responded to questions regarding satisfaction with quality of care, and 2069 (89.6%) reported satisfaction with care. Dissatisfaction with waiting time was reported by 177 (7.6%), building quality by 59 (2.6%), overall quality of care by 18 (0.8%), health care worker attitudes by 16 (0.7%), and health care worker skills by 15 (0.7%). After adjusting for age and site, there was no significant difference in viral suppression between those who were satisfied with care and those who were dissatisfied (aPR: 1.03, 95% CI 0.97–1.09). Satisfaction with HIV care was moderately associated with ART adherence among AFRICOS participants (aPR: 1.09; 95% CI 1.00–1.16). Conclusions While patient satisfaction in AFRICOS was high and the association between perceived quality of care and adherence to ART was marginal, we did identify potential target areas for HIV care improvement, including reducing clinic waiting times.

A critical review analysis of the issues arising out of the clinical practice by an infected health care worker

The way communicable diseases do spread from one person to another, depending upon the specific disease or causative infectious agent. Out of these diseases, some are incurable and the health care workers during their practice or otherwise acquire such infections and transmit them further to innocent patients who are unaware of about the health status of health care workers. The rights of an infected health care worker and patients are protected by many laws but in case of conflict of interests between the individual right of the health care worker and life of a patient, then obviously by the principle of natural justice, saving the life of a person from such incurable infection gets the privilege. Therefore, there is a lot of ethical and professional dilemma, arising out, in such a type of scenario, irrespective of concealed or disclosed health status and the question mark is raised on whether clinical practice may be allowed in such cases. Some of the studies show the actual but very little risk of transmission from infected health care workers to patients. Therefore, in the current scenario, many western countries such as USA and UK are following different guidelines in this regard but the same is lacking in India. So, this article critically analyses the various issues arising out of it and thereby justifies the need to have a uniform infection control policy in this regard apart from legal and ethical binding on infected health care workers.

What We Need to Do to Improve Our Immune System Despite the Use of Vaccination for COVID-19?

In our daily practice, we have heard more and more frequent reports of people infected with SARS-CoV-2, even having received one or two doses of vaccine for COVID-19. In the article written by Angel et al. (2021) entitled Association Between Vaccination with BNT162b2 and Incidence of Symptomatic and Asymptomatic SARS-CoV-2 Infections Among Health Care Workers, the authors concluded that the effectiveness of the vaccine in symptomatic SARS-CoV-2 infection reduced the incidence of this infection if you compared with unvaccinated health care worker. But the incidence was not reduced in the asymptomatic health care workers, where they found that vaccinated people were more likely to have SARS-CoV-2 if compared to unvaccinated people.

A Questionnaire Survey of Personal and Occupational Variables Associated With SARS-COV-2 Infection in Health Care Personnel of the Spanish Central Military Hospital

ABSTRACT Introduction Spain is the country with the highest number of health care workers affected by coronavirus disease 2019 (COVID-19) in the world. The aim of this study was to describe the epidemiology of severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) infection in health care worker (HCW) at the Gómez Ulla Military Hospital (HCDGU). Materials and Methods A case-control study was conducted during the first outbreak of COVID 19 at GUMH. The study was extended to the total number of HCW in the hospital who met the inclusion criteria. Health care worker of the HCDGU were civilian and military personnel that included nursing and medicine students of Spanish Military Academy, medicine specialty residents, and nursing residents of Medical Surgical Specialty in Operations (EMQO). A questionnaire of 33 items was prepared. The questionnaire was sent by e-mail to the entire population of study. With this questionnaire personnel were classified into sick (cases) or healthy. Results and Conclusions One hundred fifty professionals answered the questionnaire. Cases were defined as those who tested positive in the diagnostic tests (n = 28, 20.7%) and no cases were those who tested negative (n = 107, 79.3%). Therefore, the percentage of SARS-CoV-2 in the GUMH was 20.7%. Of the total number of cases, 64.3% were men (P &lt; .05), with a mean age of 47.1 years (SD 13.3), a mean BMI of 25.3 (SD 3.8), and 48.2% being overweight. Of the total cases, 59.3% had “A” blood group type and 69.2% were Rh positive. 50% were physicians, 32.1% were nurses, and 17.9% were auxiliary nurses (P &lt; .05). Cases and controls with vitamin D deficiency and who took supplements had a lower risk of suffering COVID-19, with significant differences. Fever, cough, and diarrhea were found in at least 50% of the samples with significant differences.